In two recent criminal cases, judges have
reduced the sentences for violent crimes committed under influence of antidepressants.
In each case, the judges responded to expert testimony by psychiatrist Peter
R. Breggin, M.D. concerning the adverse mental and behavior effects of SSRI
antidepressants, specifically Prozac and Paxil. Both judges concluded
that the medications contributed to the crimes and in post-conviction hearings
they reduced the sentences of the two men.
Dr. Breggin has been an expert in other criminal
and civil cases involving similar SSRI antidepressants, including Zoloft,
Celexa and Luvox.

A Case of Paxil-Induced Mania and Aggression

In November 2001 in Charlestown, South Carolina,
Dr. Breggin testified at a sentencing hearing before Judge Edward E. Cottinham.
A 27-year-old man with no prior history of violence pleaded guilty to charges
of rape. Dr. Breggin presented evidence that Paxil can cause mania
with disinhibition and aggressive sexuality, and that a Paxil-induced Mood
Disorder caused or contributed to the defendant's actions. Dr. Breggin
described the FDA approval process and related topics. Despite his
initial skepticism, the judge concluded that Paxil did contribute to the
man's crime. Instead of sentencing him to two consecutive life sentences
with no hope of parole, he gave him a more limited 21-year sentence with
actual release in 19 years.
The hearing was held in the Charleston County General
Sessions Court on November 15, 2001. The attorney for the defendant
was Andrew Savage.

A Case of Prozac-Induced Violence

Earlier in 2001 in Abington, Virginia, Dr. Breggin
testified in a jury trial presided over by Judge Charles H. Smith, Jr.
The case involved a man who shot his estranged wife and a deputy sheriff who
was trying to protect her. Fortunately, the victims recovered.
However, the defendant was severely wounded in the shoot out. He faced
many charges including kidnapping and malicious wounding. At the time
of the incident, he was being treated with Prozac, Remeron, and BuSpar.
Dr. Breggin testified on adverse drug reactions, drug labeling, FDA procedures,
and criminal responsibility, including involuntary intoxication. The
jury found the man guilty. Judge Smith, however, set a Virginia precedent
by giving a jury instruction for involuntary intoxication. He also expressed
appreciation for Dr. Breggin's testimony.
The sentencing hearing was held before Judge Smith
in November 2001 and the judge gave the defendant a reduced sentence.
In his written opinion, Judge Smith specifically cited Dr. Breggin's original
testimony concerning the effect of the prescription drugs on the defendant's
mental condition and behavior. The attorney for the defendant was
Randall Eads.

Background Science

SSRI's (selective serotonin reuptake inhibitors)
include Prozac, Paxil, Zoloft, Luvox and Celexa. Other antidepressants,
such as Effexor, can also block the uptake of serotonin causing similar
effects. These drugs can cause suicide, violence and other criminal
acts through several mechanisms, including the following:
(1) SSRI-induced mania, sometimes (but not always)
with psychotic features, such as hallucinations or delusions. During
drug-induced mania, the individual can make elaborate plans, including robberies
or embezzlement. However, the plans are often outlandish and doomed
to failure due to obviously poor judgment. Drug-induced mania can cause
many expressions of disinhibited or out-of-control behavior, including sexual
acting out, road rage, buying sprees and shoplifting. Drug-induced mania,
even when seemingly not intense, can ruin marriages and destroy careers.
All of the features of mania are not required in order to meet the
diagnosis of Antidepressant-Induced Mood Disorder with Manic Features.
If the individual's mood is "elevated, euphoric, or irritable," the
necessary criteria are met.
(2) SSRI-induced depression or worsening of depression.
In a seemingly paradoxical effect, antidepressants can cause or worsen depression.
In controlled clinical trials for Prozac that were conducted by the manufacturer,
Eli Lilly and Company, depressed patients taking Prozac attempted suicide
more frequently than depressed patients taking placebo (sugar pill) or older
antidepressants.
(3) SSRI-induced severe anxiety and agitation,
especially in a patient already suffering from depression with anxiety and
agitation;
(4) SSRI-induced obsessions and compulsions that
motivate violence toward oneself or others.
(5) SSRI-induced akathisia, an internal sensation
of agitation or discomfort that drives a person to move about, and also
to lose impulse control. During akathisia, the inner experience of
agitation includes many unusual physical feelings, such as electricity in
the head or body. The person suffering from akathisia typically
feels compelled to move the feet when sitting, to stand, or to pace.
Akathisia is known to increase the risk of suicide and violence.
Dr. Breggin has been a medical expert in many malpractice,
product liability and criminal cases involving SSRIs (see www.breggin.com
for a limited selection). As a medical expert in 1994, Dr. Breggin provided
the scientific basis for a large series of product liability cases alleging
violence and suicide caused by Prozac. The court combined the cases
in order to allow one organized effort at discovery. This facilitated
the process of evaluating secret documents obtained from the company.
In this lead role as the medical expert for the combined cases, Dr. Breggin
reviewed internal documents from Eli Lilly & Company, the manufacturer
of Prozac, and also examined FDA materials and the scientific literature.
In a more recent product liability suit against Eli Lilly & Company,
Dr. Breggin once again had the opportunity to examine internal documents,
this time at the corporate headquarters. As far as Dr. Breggin is aware,
all of the individual Prozac product liability suits in which he has agreed
to be an expert have been settled or remain active.

Most psychiatric drugs can cause withdrawal reactions, sometimes including life-threatening emotional and physical withdrawal problems. In short, it is not only dangerous to start taking psychiatric drugs, it can also be dangerous to stop them. Withdrawal from psychiatric drugs should be done carefully under experienced clinical supervision. Methods for safely withdrawing from psychiatric drugs are discussed in Dr. Breggin's new book, Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients, and Their Families.